Bladder Diary

  • Completing a bladder diary is crucial and should be brought with you to your consultation. 

  • Record timing and volume of urine passed; and timing and volume and nature of fluid intake, over a 24hr period.

Is the complaint of waking at night to void.

It is described as 'nocturnal polyuria' when passing 1/3 of the total 24hr urine production overnight.

Affects approximately 60% of patients in their 60's.

 

It is is a notoriously difficult symptom to treat due to its multifactorial nature, and can be due to:

  • Dysfunction of the bladder and/or prostatic obstruction

  • Inappropriate fluid intake

  • Medications- diuretics, Ca-channel blockers, psychotropic drugs

  • Systemic illness- Sleep apnoea, Diabetes, Cardiac failure, Lymphoedema

  • Sleep disorders

  • Age related failure of the circadian cycle of ADH hormone.

Investigations will be tailored to determine the underlying cause and guide treatment.

Nocturia

Conservative Measures

  • Reduce fluid intake after 18.00 at night.

  • Avoid bladder stimulants- caffeine, alcohol.

  • Optimise medical conditions- sleep apnoea, diabetes, cardiac failure.

  • If you suffer with leg swelling use compression hosiery and/or elevate legs early in the evening.

  • Take Ca-channel blockers in the morning and diuretics mid-late afternoon.

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